Valvular & structural heart diseaseDiagnostic or prognostic study
3-Dimensional Echocardiographic Prediction of Left Ventricular Outflow Tract Area Prior to Transcatheter Mitral Valve Replacement
- Retrospective diagnostic accuracy study
- consecutive patients
- 2 tertiary care centres
Authors' conclusion
TEE-derived analysis provides comparable results with CT-derived metrics in predicting the neo-LVOT area and peak gradient after TMVR.
Study context
- Population
- Patients undergoing transcatheter mitral valve replacement (TMVR) at 2 tertiary care centres, October 2017 to May 2023
- Participants
- 105 consecutive patients
- Comparison
- 3D transesophageal echocardiography (TEE) vs baseline computed tomography (CT) for neo-left ventricular outflow tract (neo-LVOT) and mitral annular measurement
- Outcome
- Accuracy of 3D echocardiographic analysis vs baseline CT
Performance
As reported in the abstract
Baseline neo-LVOT prediction, TEE vs CT
- No significant bias in baseline neo-LVOT prediction between both imaging modalities
- TEE significantly underestimated mitral annular (MA) area, perimeter and medial-lateral dimension vs CT
Further findings
Predicted vs actual (postprocedural) neo-LVOT area
P TEE P < 0.001 · CT P = 0.046
| Outcome | TEE | CT |
|---|---|---|
| Correlation of predicted neo-LVOT area with postprocedural peak LVOT gradient (inverse) | ||
| r2 | 0.481 | 0.401 |
| P | P < 0.001 | P < 0.001 |
Predicted vs actual (postprocedural) neo-LVOT area
- Both modalities significantly underestimated the actual neo-LVOT area, driven by underestimation with dedicated mitral valve bioprosthesis
Original publication
3-Dimensional Echocardiographic Prediction of Left Ventricular Outflow Tract Area Prior to Transcatheter Mitral Valve Replacement. JACC Cardiovasc Imaging. Published 24 July 2024. doi:10.1016/j.jcmg.2024.05.011
Summarised from the published abstract; every number is checked against it